Risks & Prevention
In this section:
On average, someone suffers a stroke every 40 seconds and dies from a stroke every four minutes. Stroke is also a leading cause of serious, long-term disability.
North Carolina has its fair share of stroke victims — about 14,000 North Carolinians are disabled by stroke each year, and more than 5,000 residents will lose their lives.
What is Stroke?
Stroke By the Numbers
Each year about 795,000 people in the United States experience a new or recurrent stroke — making stroke the nation's fifth leading cause of death.
Simply put, a stroke is a "brain attack." It occurs when part of the body loses function due to a disruption of blood flow in the brain. When this happens, either because of blockage from buildup in the arteries or when a vessel in the brain bursts, the affected area can’t get oxygen or nutrients. This can cause a wide range of symptoms, including the following:
- Paralysis
- Vision loss
- Difficulty speaking
- Severe headache
Without oxygen rich blood and nutrients, brain cells in the affected area begin to malfunction and die. Learn more about different types of stroke.
Stroke Symptoms
Here are a few common symptoms of stroke:
- Sudden numbness or weakness of face, arm or leg, especially on one side of the body
- Sudden confusion or trouble speaking or understanding
- Sudden difficulty seeing in one or both eyes
- Sudden trouble walking, dizziness or loss of balance or coordination
- Sudden severe headache with no known cause
What About Age and Gender?
While the risk of stroke increases with age, a stroke can occur at any age, and nearly a quarter of strokes occur in people under the age of 65. Stroke affects both men and women with women having a higher lifetime risk of stroke. Although most women are more worried about getting breast cancer than they are about a stroke, twice as many women die of stroke than of breast cancer every year. During middle age, men are more likely to have a stroke than women, but the gender ratio reverses for people 85 and older, when women are more likely to experience a stroke.
What to Do If You Suspect a Stroke
Time is of the essence with a stroke. Fast action saves lives while decreasing the chances of lifelong disability, such as paralysis or blindness.
If you think you or someone you’re with is having a stroke, call 911 and get to your closest emergency department. We have skilled EMS providers in our area who can stabilize the patient and help physicians and staff prepare for the patient’s arrival.
Types of Stroke
In this section
Ischemic Stroke
Ischemic stroke is the most common type of stroke. This type of stroke can result from clogged or damaged arteries, such as in atherosclerosis or arterial dissection or blood clots that travel to the brain from other areas of the body. A clot that forms in clogged arteries in the brain is called a cerebral thrombus. A clot that breaks loose and moves through the blood to the brain is called a cerebral embolism.
Risk Factors for Ischemic Stroke:
| Hypertension (high blood pressure) | Obesity/Lack of exercise |
| Hyperlipidemia (high cholesterol) | Substance abuse |
| Diabetes | Oral contraceptive use (especially in combination with other risk factors) |
| Sleep apnea | Abnormal or mechanical heart valve |
| Certain types of migraines | Patent foramen ovale (PFO) |
| Atrial fibrillation (A-Fib) | Inflammation of the inside lining of the heart chambers and heart valves (endocarditis) |
| Smoking | Family history or personal history of stroke or transient ischemeic attack (TIA) |
Some of these risk factors can be modified with help from your primary care provider.
Hemorrhagic Stroke
Hemorrhagic stroke is a very serious form of stroke that refers to spontaneous rupture of an artery in the brain. The resulting increase in pressure, and irritating effect of blood on the brain tissue, can lead to neurologic deficits similar to an Ischemic Stroke.
Risk Factors for Hemorrhagic Stroke:
- Hypertension (high blood pressure)
- Substance and/or alcohol abuse
- Personal or family history of aneurysms or other blood vessel abnormalities (arteriovenous malformation (AVM), Amyloid Angiopathy, etc.).
- Use of certain blood thinners
Transient Ischemic Attack (TIA)
TIA, formerly known as ministrokes, are the only warning sign for stroke. Symptoms of TIA match those of stroke, but a TIA will not appear on diagnostic imaging. These are brief, episodic stroke symptoms that typically last less than 24 hours with no lasting damage.
Patients with TIA have a five-fold higher risk of stroke within five years of TIA diagnosis (Vinding et al., 2023).
Stroke Risk Assessment
Scorecard
Curious about your own risk for stroke? This scorecard from the American Stroke Association® can help determine your risk. It’s important to note, some stroke risk factors such as age, family history, race, gender and prior stroke cannot be changed. Follow the directions below to get started, and speak with your health care professional about how you can reduce your risk of stroke if you scored higher in the “higher risk” column or if you are unsure of your risk.
Did you know that 80% of strokes are preventable?
To lower your risk for a first stroke, follow these guidelines from the National Stroke Association:
- Know your blood pressure and work with your doctor to prevent or reduce high blood pressure.
- Find out if you have atrial fibrillation.
- If you smoke, take steps to quit. Try our smoking cessation program, Quit With WakeMed.
- If you drink alcohol, do so in moderation.
- If you have diabetes, work with your doctor to find the right medication, and make lifestyle changes.
- Include exercise in the activities you enjoy in your daily routine.
- Find out if you have high cholesterol.
- Enjoy a lower sodium (salt), lower fat diet.
- Ask your doctor if you have circulation problems.
Learn to recognize the symptoms of stroke:
- Sudden numbness or weakness of face, arm or leg, especially on one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden difficulty seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden severe headache with no known cause
Use the acronym B.E. F.A.S.T. to remember:
B – BALANCE – Watch the person walk. Is the person losing coordination or balance?
E – EYES – Ask about eyesight. Is the person having trouble seeing out of one or both eyes?
F – FACE – Ask the person to smile. Does their face droop down on one side or look uneven?
A – ARM – Ask the person to raise both arms. Does one arm drift downward?
S – SPEECH – Ask the person to repeat a simple phrase such as “the sky is blue.” Do the words sound strange or slurred?
T – TIME – Time is critical. If you notice any of the symptoms of stroke, call 911 immediately.
Do not drive yourself or the person to the hospital. Paramedics can begin to help stop a stroke in the field. The longer the brain is starved of oxygen, the greater the chances of death or permanent disability.
Preventing a Stroke
What You Can Do
Knowing your family history and getting regular check-ups are important factors in staying healthy. Try these tips to help prevent a stroke:
- Quitting smoking can significantly reduce your risk of stroke. Consider Quit with WakeMed, our tobacco cessation program.
- Change your diet. Eat a low-fat diet rich in vegetables, fruits and low-fat dairy foods, and reduce your sodium intake.
- Lose excess weight.
- Exercise regularly. Get 40 minutes or more of aerobic activity most days of the week.
- If you drink alcohol, do so in moderation.
- Get your blood pressure checked every one to two years, especially if high blood pressure runs in your family.
- Have your cholesterol checked. If you’re at high risk for stroke, your LDL "bad" cholesterol should be lower than 100 mg/dL. Your doctor may recommend that you try to reduce your LDL cholesterol to 70 mg/dL.
- Find out if you have an irregular heartbeat, atrial fibrillation or circulation problems.
- Follow your doctor's treatment recommendations if you have high blood pressure, diabetes, high cholesterol or heart disease.
Reduce Your Blood Pressure — Helpful Tips
- Lose excess weight.
- Exercise Daily — Get 40 minutes or more of aerobic activity most days of the week.
- Change Your Diet — Eat a low-fat diet rich in vegetables, fruits and low-fat dairy foods, and reduce your sodium intake.
- Limit Sodium — Try to take in less than 2,000 mg of sodium a day. Read food labels to know how much sodium you are consuming. Put away the salt shaker. Try other spices and herbs to add flavor to your foods.
- Quit Smoking — One of the best steps you can take to improve your blood pressure, heart and brain health.
- Reduce Stress — Through regular exercise, better time management, meditation or laughter, find the best outlet to reduce your stress.
Learn more at the American Heart Association.
Education for Kids
A stroke can also be called a "brain attack." Stroke happens when the blood flow to the brain stops or is interrupted. Without blood flow, brain cells do not get enough oxygen and can die. Stroke has the potential to cause:
- Paralysis — Complete or partial loss of movement
- Aphasia — Loss of speech
Helping Prevent Stroke
People can help reduce their chances of having a stroke by:
- Eating a healthy, well-balanced diet.
- Exercising regularly.
- Not smoking cigarettes or using drugs; drinking alcohol only in moderation.
- Having regular medical check-ups with the doctor.
- Actively managing conditions such as high blood pressure, diabetes, high cholesterol and heart problems.
Test Your Knowledge!
Take this short quiz 
by the National Stroke Association that will test your knowledge about stroke.
Other Activities
Below are some other resources from the National Stroke Association that will help you learn more about the brain and stroke.
Brainiac Kids Crossword Puzzle
Hip Hop Stroke Brain Map
Brainiac B's Word Find